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The Transforming growth factor beta (TGF-β) superfamily consists of over 30 structurally related pleiotropic ligands, including TGF-betas, bone morphogenetic proteins (BMPs), activins, and growth and differentiation factors (GDFs). These ligands are essential for regulating a vast array of biological processes such as cell proliferation, differentiation, apoptosis, and immune response across nearly all tissue types (NIH, 1.2.1, 1.3.5). They signal through a complex of type I and type II serine/threonine kinase receptors to activate canonical SMAD-dependent and various non-canonical pathways (NIH, 1.3.1, 1.3.3). While critical for normal development and homeostasis, the dysregulation of these ligands is a primary driver of several pathologies, most notably cancer metastasis, tissue fibrosis (liver, lung, kidney), and musculoskeletal disorders (NIH, 1.2.3, 1.3.4). Therapeutic strategies targeting this group include neutralizing monoclonal antibodies like fresolimumab, soluble receptor "traps" like luspatercept, and antisense oligonucleotides like trabedersen (NIH, 1.1.4, 1.2.4). However, drug development is significantly challenged by the ligands' pleiotropic nature, which can lead to systemic toxicities such as cardiotoxicity and the development of skin malignancies (NIH, 1.2.3, 1.4.2).
Ligand neutralization, Ligand trapping, Inhibition of ligand activation, Antisense-mediated knockdown of ligand expression
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